Skip to main content
Sign inSign up

ADSA Society

Logo
IssuesFor AuthorsAdvertisingNewsHelp

ADSA Society

Article Contents

  • CASE REPORT
  • DISCUSSION
  • REFERENCES
Save
Download PDF

A 54-year-old woman diagnosed with multiple sclerosis (MS) at the age of 19 years was scheduled to undergo temporomandibular joint mobilization. She was currently in a remission phase from her MS but with persistent sequelae, including impaired eyesight and muscle weakness of the limbs. In addition, the blood vessels in her upper limbs were compromised by the formation of internal shunts secondary to vascular prosthesis replacements for plasma exchange therapy in MS. After a previous joint mobilization surgery, her temporomandibular joint developed adhesions with resultant trismus. One of the adverse effects of general anesthesia can be exacerbations of MS symptoms. Minimizing mental and physical stress caused by surgical and anesthetic procedures and maintenance of stable body temperature are important considerations. Awake intubation was performed under sedation with midazolam and fentanyl. After intubation, anesthesia was induced with propofol, remifentanil, and rocuronium. Maintenance of anesthesia was achieved with oxygen-N2O-sevoflurane, remifentanil, fentanyl, and rocuronium. In this case, no adverse events occurred intraoperatively. However, the patient experienced lingering weakness of the limbs in the postoperative period, and activities of daily living of the patient were affected.

Keywords: Multiple sclerosis; Demyelinating encephalomyelitis; Trismus
  • Download PDF
Copyright: © 2017 by the American Dental Society of Anesthesiology
Citations

Get Email Alerts

Article Contents
ANPR logo
AboutIssuesAuthor InformationSubscriptions

ADSA Society

eISSN: 1878-7177

ISSN: 0003-3006

Powered by PubFactory